COPD Winter Readiness

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          "description": "Number and percentage of patients coded as having COPD, including  break down by deprivation, location (place, PCN and  practice), sex and ethnicity",
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          "description": "# and % of patients with COPD categorised as high and \nmoderate risk following risk stratification, including break \ndown by deprivation, location (place, PCN and practice), \nsex and ethnicity",
          "id": "2",
          "observations": [
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          "title": "High risk patients"
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        {
          "description": "# and % of patients with COPD categorised as high and \nmoderate risk who have been contacted, including break \ndown by deprivation, location (place, PCN and practice), \nsex and ethnicity",
          "id": "3",
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          "title": "Levels of contact"
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          "description": "# and % of patients with COPD categorised as high and \nmoderate risk who have been reviewed, including break \ndown by deprivation, location (place, PCN and practice), \nsex and ethnicity",
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        {
          "description": "# and % of patients who have been reviewed and have \nhad a recommended medication change, including break \ndown by deprivation, location (place, PCN and practice), \nsex and ethnicity",
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          "title": "Recommended medication change"
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          "description": "# and % of patients who are prescribed medication in \nalignment with guidelines, including break down by \ndeprivation, location (place, PCN and practice), sex and \nethnicity",
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          "title": "Adherence to guidelines"
        },
        {
          "description": "# and % of patients who have an agreed care plan in \nplace, including break down by deprivation, location \n(place, PCN and practice), sex and ethnicity",
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          "title": "Care planning"
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      "dateSigned": "2025-11-04T00:00:00Z",
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      "address": {
        "country": "GB",
        "countryName": "United Kingdom",
        "locality": "Norwich",
        "postalCode": "NR1 2DH",
        "region": "UKH15",
        "streetAddress": "8th Floor, County Hall, Martineau Lane"
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      "name": "NHS NORFOLK AND WAVENEY INTEGRATED CARE BOARD",
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  "tender": {
    "description": "Chronic Obstructive Pulmonary Disease (COPD) exacerbations have a considerable impact on healthcare costs and mortality rates, with over one-fifth of patients hospitalised for a COPD exacerbation for the first time and subsequent mortality within one year of discharge. Exacerbations of COPD account for one in every eight admissions, increasing by around 13% each year and are the second largest cause of Emergency Department (ED) admissions in the UK.\nCOPD exacerbation\u0027s significantly rise during colder months, with approximately 50% increased hospital admissions for COPD patients in winter compared to summer months. For every degree drop in temperature below 5 \u00b0C, there is a 10.5% increase in primary care respiratory consultations and a 0.8% increase in respiratory admissions.\nThe cost of respiratory care for COPD across Norfolk and Waveney is estimated to increase by 11% over the next ten years. Respiratory diseases are more prevalent in areas of social deprivation due to factors such as higher smoking rates, exposure to air pollution, and poorer housing conditions. These health inequalities lead to worse health outcomes and a widening gap between the rich and poor in respiratory disease mortality.\nEarly intervention and improving the treatment of people with COPD is part of ICB\u0027s Prevention Programme. This project seeks to utilise public health management data, mitigate health inequalities and improve accessibility through risk stratification and review utilisation of digital technology for patients with moderate to severe COPD, who would benefit from proactive patient identification, engagement and medicines optimisation\nThe project can only be delivered through to utilisation of LungHealth COPD software provided by NSHI. The software is a proven product, and carries full NHS digital accreditation (ORCHA and DTAC) and is listed on the LPP NHS Framework.\nThe Quality Outcomes Framework lists the prevalence of COPD in Norfolk and Waveney at 2.3%, (England average 1.9%) (QOF, 2021-22). N\u0026W ICB serve a combined population of 24,429 Chronic Obstructive Pulmonary Disease (COPD) patients.\nThis project supports the N\u0026W ICS five-year joint forward plan (N\u0026WICS, 2025) and the development of integrated care. Four key themes: Driving integration; Prioritising prevention; Addressing inequalities; Enabling resilient communities.\nThe COPD Winter Readiness project is a collaborative, quality improvement programme. Implemented at an ICB level aimed at providing additional resources into primary care to accelerated timely and equitable access for patients with moderate to severe COPD to appropriate care and treatment, by deploying a digitally enabled, pathway to proactively identify, risk-stratify, and triage patients to appropriate care at the population level without additional primary care capacity requirements.\nThis is the second of 2 phases covering 20 Norfolk and Waveney GP Practices funded by Norfolk and Waveney ICB covering 37 practices.\nTriple lock funding approval - ICB NP348 awarded on 04/08/25",
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    ],
    "id": "2025-041",
    "legalBasis": {
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    "procurementMethod": "direct",
    "procurementMethodDetails": "Direct award",
    "procurementMethodRationale": "The project can only be delivered through utilisation of LungHealth Chronic Obstructive Pulmonary Disease (COPD) software provided by NSHI. The software is proven product and carries full NHS digital accreditation (ORCHA and DTAC) and is listed on the LPP NHS Framework.\nEarly intervention and improving the treatment of people with COPD is part of ICB\u0027s Prevention Programme. This project seeks to utilise public health management data, mitigate health inequalities and improve accessibility through risk stratification and review utilising digital technology, of patients with moderate to severe COPD, who would benefit from care planning and optimal guideline driven medication therapy.\nAccording to Quality Outcomes Framework, Norfolk and Waveney: COPD prevalence equates to 2.3%, (England average 1.9%) (QOF, 2021-22). \tNHS Norfolk and Waveney Integrated Care Board (ICB) serving a combined population of 24,429 COPD patients. Project supports NHS Norfolk and Waveney ICS five-year joint forward plan and the development of integrated care. Four key themes: Driving integration; Prioritising prevention; Addressing inequalities; Enabling resilient communities.\nThe COPD Winter Readiness project is a collaborative, quality improvement programme. Implemented at an ICB level aimed at providing additional resources into primary care to accelerated timely and equitable access for patients with moderate to severe COPD to appropriate care and treatment, by deploying a digitally enabled, pathway to proactively identify, risk-stratify, and triage patients to appropriate care at the population level without additional primary care capacity requirements.",
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    "status": "complete",
    "title": "COPD Winter Readiness"
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}